Usual Source of Care

A basic element of a medical home is a regular
place that children can go—whether it be a doctor’s
office, clinic, or health center—when they are
sick. The survey asked parents whether there is a
place, and what kind of place, the family usually
goes when the child is sick or when the family
needs advice about the child’s health.

Overall, 90.7 percent of CSHCN have a usual
source of sick care. For the majority of children
(74.9 percent), this is a doctor’s office; for 11.2
percent, it is a clinic or health center; and for 4.6
percent it is another setting. The parents of just
7.4 percent of CSHCN report that their child has
no usual source of care, and an additional 2.0
percent rely on a hospital emergency department.

Children with private insurance are more likely
than those with public insurance, who in turn are
more likely than uninsured children, to have a usual
source of care. Of CSHCN with private insurance,
83.1 percent go to a doctor’s office and 6.7
percent a clinic or health center, while 6.3 percent
are reported to have no usual source of care. Of
those with public insurance, whether alone or in
combination with private insurance, two-thirds go
to a doctor’s office and 15.8 percent to a clinic,
while approximately 8 percent have no usual
source of care. Of uninsured CSHCN, just over
half go to a doctor’s office and 19.8 percent to a
clinic or health center, and 14.4 percent have no
usual source of care.

A similar disparity is seen by race and ethnicity.
While the majority of children in each racial and
ethnic group go to a doctor’s office for their regular
care, this percentage ranges from 60.8 percent
among Hispanic children to 81.4 percent
among non-Hispanic Whites. Likewise, the percentage
that go to a clinic or health center ranges
from 7.6 percent of non-Hispanic White children
to 22.5 percent of Hispanics, and the percentage
with no usual source of care from 6.3 percent of
non-Hispanic Whites to 9.3 percent of non-Hispanic
Blacks.

Suggested Citation: U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. The National Survey of Children with Special Health Care Needs Chartbook 2009–2010. Rockville, Maryland: U.S. Department of Health and Human Services, 2013.